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| 1 | Transarterial chemoembolization using degradable starch microspheres and iodized oil in the treatment of advanced hepatocellular carcinoma: evaluation of tumor response, toxicity, and survival显示文摘BACKGROUND: In a multidisciplinary conference patients with advanced non-resectable hepatocellular carcinoma (HCC) were stratified according to their clinical status and tumor extent to different regional modalities or to best supportive care. The present study evaluated all patients who were stratified to repeated transarterial chemoembolization (TACE) from 1999 until 2003 in terms of tumor response, toxicity, and survival. A moderate embolizing approach was chosen using a combination of degradable starch microspheres (DSM) and iodized oil (Lipiodol) in order to combine anti-tumoral efficiency and low toxicity. METHODS: Fourty-seven patients were followed up prospectively. TACE treatment consisted of cisplatin (50 mg/m2), doxorubicin (50 mg/m2), 450-900 mg DSM, and 5-30 ml Lipiodol. DSM and Lipiodol were administered according to tumor vascularization. Patient characteristics,toxicity, and complications were outlined. In multivariate regression analyses of pre-treatment variables from a prospective database, predictors for tumor response and survival after TACE were determined. RESULTS: 112 TACE courses were performed (2.4±1.5 courses per patient). Mean maximum tumor size was 75 (± 43) mm, in 68% there was bilobar disease. Best response to TACE treatment was: progressive disease (PD) 9%, stable disease (SD) 55%, partial remission (PR) 36%, and complete remission (CR) 0%. Multivariate regression analyses identified tumor size ≤75 mm, tumor number ≤5, and tumor hypervascularization as predictors for PR. The overall 1-, 2-, and 3-year-survival rates were 75%, 59%, and 41%, respectively, and the median survival was 26 months. Low α-fetoprotein levels (<400 ng/ml) (Odds ratio=3.3) and PR as best response to TACE (Odds ratio=6.7) were significantly associated with long term survival (>30 months, R2=36%). Grade 3 toxicity occurred in 7.1% (n=8), and grade 4 toxicity in 3.6% (n=4) of all courses in terms of reversible leukopenia and thrombocytopenia. The incidence of major complications was 5.4% (n=6). All complications were managed conservatively. The mortality within 6 weeks after TACE was 2.1% (one patient). CONCLUSIONS: DSM and Lipiodol were combined successfully in the palliative TACE treatment of advanced HCC resulting in high rates of tumor response and survival at limited toxicity. Favourable tumor response was associated with tumor extent and vascularization. TACE using DSM and Lipiodol can be considered a suitable palliative measure in patients who might not tolerate long acting embolizing agents. | Timm D Kirchhoff Joerg S Bleck Arne Dettmer Ajay Chavan Herbert Rosenthal Sonja Merkesdal Bernd Frericks Lars Zender Nisar P Malek Tim F Greten Stefan Kubicka Michael P Manns Michael Galanski | 2007 | Hepatobiliary & Pancreatic Diseases International2007，6，3： | 15 |
| 2 | Combination of repeated single-session percutaneous ethanol injection and transarterial chemoembolisation compared to repeated single-session percutaneous ethanol injection in patients with non-resectable hepatocellular carcinoma显示文摘瞄准:为病人评估经皮的乙醇注射(PEI ) 的治疗效果与先进, non-resectable HCC 与 transarterial chemoembolisation 的联合相比(不作声) 并且重复单个会议的 PEI,独自重复了单个会议的 PEI,重复不作声独自一个,或最好的支持的照顾。方法:在学习时期期间接受了 PEI 治疗的所有病人根据物理地位和肿瘤程度被包括并且成层到下列治疗形式之一:联合不作声并且重复单个会议的 PEI,独自重复了单个会议的 PEI,重复不作声独自一个,或最好的支持的照顾。包括Okuda分类,门静脉血栓的存在,腹水的存在,肿瘤的数字,最大的肿瘤直径,和假胆硷酯酶( CHE )的临床的参数的预示的价值,以及孩子呸上演, alpha-fetoprotein (法新社),发烧,复杂并发症的发生在这些组之间被估计并且比较。幸存用 Kaplan-Meier 被决定,多,变量回归分析。结果:所有病人的 1 年、 3 年的幸存是 73% 和 47% 。在亚群分析,联合不作声, PEI (1 ) 与更长的幸存被联系(1- , 3- , 5 年的幸存:90% , 52% ,和 43%) 与 PEI 治疗相比独自一个(2 )(1- , 3- , 5 年的幸存:65% , 50% ,和 37%) 。(3 ) 在起始的层化以后的第二等的 PEI 产出可比较的结果不作声(1- , 3- , 5 年的幸存:91% , 40% ,和 30%) 当在到最好的支持的照顾(4 ) 的层化以后的 PEI 与减少的幸存被联系时(1- , 3- , 5 年的幸存:50% , 23% , 12%) 。除了选择治疗形式,为更好的幸存的预言者是肿瘤数字(n <
5 ) ,肿瘤尺寸(<
5 厘米) ,在 PEI 前的没有腹水,和在 PEI 以后的稳定的假胆硷酯酶(P <
0.05 ) 。在在 PEI 以后的 2 wk 以内的死亡是 2.8%(n = 3 ) 。有 24 (8.9%) 主修在包括部分肝梗塞,焦点的肝坏死,和肝脓肿的 PEI 以后的复杂并发症。所有复杂并发症能非通过手术被管理。结论:重复单个会议的 PEI 在有以可接受、可管理的复杂并发症率的先进 HCC 的病人是有效的。病人们成层到联合不作声, PEI 能比那些独自成层到重复 PEI 期望更长的幸存。而且,有在好临床的地位的大或多重的肿瘤的病人可以也从联合获利不作声并且为第二等的 PEI 的再考虑。 | Arne Dettmer Timm D Kirchhoff Michael Gebel Lars Zender Nisar P Malek Bernhard Panning Ajay Chavan Herbert Rosenthal Stefan Kubicka Susanne Krusche Sonja Merkesdal Michael Galanski Michael P Manns Joerg S Bleck | 2006 | World Journal of Gastroenterology2006，12，23： | 14 |
| 3 | 澳大利亚初级保健诊所新发腰背痛患者的预后:起始队列研究显示文摘目的估计初级保健诊所内新发腰背痛患者的1年预后,并确定其预后因素。设计1年随访队列研究。地点澳大利亚悉尼的初级保健诊所。参试者初级保健诊所接诊的973例非特异性腰背痛连续患者(平均年龄43.3岁,男性54.8%)。该起始队列患者腰背痛时间不足两周,征集自170名全科医生、理疗师或按摩师诊所。主要评估指标参试者完成基线调查问卷后,分别于初次就诊后6周、3个月和21个月时复查评估。评估内容包括:工作恢复情况、功能恢复情况和疼痛消失情况。潜在预后因素与恢复所需时间的关联性用Cox回归建模分析。结果12个月随访率〉97%。基线时工作能力下降的患者半数在14天内恢复了以前的工作状态(95%可信区间11-17天),83%在3个月内恢复。残疾(中位恢复时间31天,25-37天)和疼痛(中位58天,52-63天)则需要较长的时间才能恢复。只有72%的受试者于基线访问后12个月获得完全康复。高龄、赔偿诉讼、疼痛较重、就诊前腰背痛时间较长、就诊前因疼痛活动减少天数较多、抑郁情绪以及预期危险持续与所需恢复时问较长相关。结论在这个急性腰背痛初级保健患者队列,患者的预后并不像临床指南声称的那样乐观。多数患者的恢复缓慢。近三分之一的患者在腰背痛发作后1年尚未恢复。 | Nicholas Henschke Christopher G Maher Kathryn M Refshauge Robert D Herbert Robert G Cumming Jane Bleasel John York Anurina Das James H McAuley 蓝恭涛(译) | 2008 | 英国医学杂志中文版2008，11，6： | 2 |
| 4 | Accelerated Cooling of Steel Plates: The Time Has Come显示文摘 | Antonio A G Jose Herbert D S | 2008 | Journal of ASTM International2008，5，8： | 1 |
| 5 | Clopidogrel, a novel antiplatelet and antithrombotic agent显示文摘 | Herbert MJ Frehel D Vallee E | 1993 | Cardiovasc Drug Rev1993，11，2： | 1 |
| 6 | Acute low back pain: systematic review of its prognosis 显示文摘 | Pengel L H Herbert R D Maher C G | 2003 | BMJ2003，327，7410： | 1 |
| 7 | Fermentation of hexose and pentose sugars using a novel ethanologenic Escherichia coli strain显示文摘 | Robert B H Herbert A W Rodney J B | 1998 | Enzyme and Microbial Technology1998，23，： | 1 |
| 8 | Artistic and literary places in France as tourist attractions显示文摘 | D T Herbert | 1996 | Tourism Management1996，17，2： | 1 |
| 9 | Coupled groundwater flow and solute transport with fluid density strongly dependent upon concentration显示文摘 | Jackson C P Lever D A | 1988 | Water Resource Research1988，24，10： | 1 |
| 10 | Biochemical and pharmacological properties of clopidogrel:a new ADP receptor antagonist显示文摘 | Herbert JM Frehel D Valle E | 1999 | Eur Heart J1999，，： | 1 |
| 11 | Factors impacting human telomere homeostasis and age-related disease 显示文摘 | Gilley D Herbert B S Huda N | 2008 | Mech Ageing Dev2008，129，12： | 1 |
| 12 | Blood gas tensions and acid - base balance in awake cats 显示文摘 | HERBERT D A MITCHELL R A | 1971 | J Appl Physiol1971，30，3： | 1 |
| 13 | Improvement in cognitive function following a switch to ziprasidone from conventional antipsychotics,olanzapine,or risperidone in outpatients with schizophrenia显示文摘 | Philip D Harvey Herbert Meltzer | 2004 | Schizophr Res2004，66，： | 1 |
| 14 | Clopidogrel,anovel antiplatelet and antithrom botic anget显示文摘 | Herbert M J Frehel D Vallee E | 1993 | Cardiovascular Drug Reviews1993，11，2： | 1 |
| 15 | A model for the distribution of residential activity in urban areas 显示文摘 | Herbert J D Stevens B H | 1960 | Journal of Regional Science1960，2，2： | 1 |
| 16 | Intradis- eal pressur measurements above an instrumented fusiona eadavefic study显示文摘 | WEINHOFFER S L GUYER R D HERBERT M | 1995 | Spine1995，20，5： | 1 |
| 17 | Shape and frequency composition of pulses from an impact pair显示文摘 | Herbert R G McWhannell D C | | 0，，03： | 1 |
| 18 | Bacteria active in the spoilage of certain sea foods 显示文摘 | Herbert R A Hendrie M S Gibson D M | 1971 | J Appl Bacteriol1971，34，： | 1 |
| 19 | Tamponade efficiency of perfluorohexyloctane and silicone oil solutions in a model eye chamber显示文摘 | Wetterqvist C Wong D Williams R Stappler T Herbert E Freeburn S | 2004 | Br J Ophthalmol2004，88，： | 1 |
| 20 | An algal assay method for determination of copper complexation capacities of natural waters 显示文摘 | Herbert E A Carol B Thomas D B | 1983 | Bull Environ Contam Toxi- clo1983，30，： | 1 |
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